Abnormal nails

Introduction A includes the deck, the nail bed and the nail week. The nail abnormality involves the above three parts. The factors that cause nail lesions are classified as congenital or acquired. Congenital nail lesions often associated with other congenital anomalies. Acquired nail lesions are found in microbial infections and local factors. Abnormal changes in nails caused by systemic diseases or certain skin diseases. There may also be damage to the original nail for unknown reasons. The mechanism of nail damage is generally related to its cause. A lesion caused by congenital factors and congenital hyperthyroidism syndrome are often accompanied by other congenital anomalies.

Cause

There may be genetic factors in the family history of the disease. A disease caused by acquired factors, the pathogenesis is different, such as infectious nail disease due to the gingival and nail bed inflammation caused by pathological changes in the deck. Non-infectious nail disease can directly damage the deck, nail bed or damage to the deck due to local physical and chemical trauma. A new organism that occurs under the nail wall or under the nail can cause changes in the deck, such as a sacral sac, a subcutaneous glomus tumor, an exogenous osteoma, a suppurative granuloma, and a periungual carcinoma. damage.

Some systemic diseases can cause nail lesions due to endocrine factors, ischemia and hypoxia, and peripheral circulatory disorders. Some dermatological lesions are part of their clinical manifestations, such as psoriasis, which can thicken the deck, squat, and thimble-like pits. It can also cause abnormal changes of nails due to invasion of the skin lesions, such as continuous acrodermatitis and hand eczema.

an examination

Related inspection

Trace elements in the human body, fungi, vitamins

(1) medical history

A detailed medical history is helpful for diagnosis. Such as the age of onset, the stage of disease, the presence or absence of symmetry and accompanying diseases. Infantile nail disease is more common in congenital factors. If accompanied by other congenital abnormalities, it is often a disease syndrome. Understand the cause of the disease to determine whether it is infectious or non-infectious. Acute infection of infectious nail disease may have an inflammatory reaction, which is characterized by red J, heat and pain. It is unilateral or only infringes one nail. Hyperthyroidism has no manifestations of acute inflammation, but generally has hand and foot spasms, and then spread to the nails. The thumb (toe) is more susceptible, and often involves multiple nails after asymmetry.

A single or only one nail is also seen in nail damage caused by trauma, physical, chemical or local new organisms. A disease caused by a systemic disease or certain skin diseases manifests as multiple nails and is symmetrically distributed. Such as anemia, psoriasis and so on. The evolution process and treatment of nail damage have reference significance for diagnosis. For example, the nail damage of psoriasis and eczema changes with the severity of the primary disease, and the recovery of the primary disease with the primary disease will also recover.

(2) Physical examination

In the case of a lesion, the deck, the sulcus and the nail bed should be examined in detail. Observe the number of nail damage, the length of involvement, and the presence or absence of symmetry damage. Also observe the texture, smoothness, and color of nail A. Also check the general condition, systemic systemic disease or other congenital anomalies.

(3) Laboratory inspection

When considering hyperthyroidism, the diseased nail or nail bed debris can be scraped, and direct microscopic examination and culture of the fungus can help diagnose the hyperthyroidism. Fungal species can be identified by culture. Bacterial nail damage can be done in bacterial culture if there is a purulent infection. Some of the desirable decks, the tissue of the nail bed for pathological sectioning, contribute to the diagnosis of nail damage. Toxic nail damage can determine the syphilis serum response. Determining the microcirculation of the nail wall is meaningful for certain nail lesions. For example, a nail damage caused by connective tissue disease, blood vessels of the wrinkle wall become smaller, blood flow is reduced or embolism occurs.

Differential diagnosis

The diagnosis should be differentiated from the following symptoms:

Nail barb: The barb usually grows beside the nail. It will cause pain and cause inconvenience. When the barb is pulled, the surrounding skin will be injured, and even blood will be caused, resulting in hand infection. Most of them appear in the autumn and winter seasons.

The nail is concave, which means that there are some horizontal stripes, vertical stripes and spots on the nails. This change in nails is closely related to the low function of the tissues and organs of the body, and the pathological changes such as destruction and atrophy of the tissue structure.

The nail is black and the nail looks black, suggesting an endocrine disorder, which can also occur with a long illness.

Short nails are symptoms of short nail length. A quadrangular woman with gynecological diseases and thus affects fertility. The nails are very short, and the quadrangular person has a heart system disease. If the nail is cyan, it has cardiovascular neurosis, and if it turns into a cyan or purple color, it means that the heart disease has deteriorated.

A triangular shape of a nail refers to a symptom in which the shape of the nail is triangular or inversely triangular. People with triangular nails are prone to digestive diseases and laryngitis. The shape of the triangle is opposite to the former, and people with an inverse triangle are prone to diabetes and pneumonia. Fan-shaped (inverse triangle) born on the drumstick finger must have heart, brain, disease blood circulation, such as stroke, spinal cord embolism. The nail is flat and the shape of the nail is flat. A lesion in the neck of the lymph gland or throat causes the shape of the nail to be flat.

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